Can Dementia be Caused by Medications?
Medication Side Effects
Medications all have some side effects, such as side stomach upset, constipation, dry mouth, and many more depending on the particular medication. I was given Ketamine during back surgery about 3 years ago, and I had a horrible reaction. I had vivid nightmares and when I awoke I believed the nightmares were true. It took about a week for the nightmares to subside.
Hospital delirium can occur for senior citizens as a reaction to the medications. Recently, there was a very large study completed by the University of Nottingham on the link between medications and dementia.
Medical Research on Medications
The University of Nottingham, UK, recently analyzed records for 58,769 participants above age 55 with dementia and 225,574 patients without dementia. The patients with dementia were 63% female, with an average age of 82. They looked for particular drugs that might increase the risk of dementia. The primary medications responsible are from a group called Anticholinergics, which work by inhibiting the chemical messenger known as acetylcholine.
Anticholinergics are a group of medications that block the neurotransmitter’s typical action as a chemical messenger in the brain, which is responsible for transferring signals between cells. These cells affect specific body functions. The medications are typically prescribed for a gastrointestinal problem, an overactive bladder, depression, vertigo and to treat some of the symptoms of Parkinson’s disease.
Patients with known risk factors, such as alcohol use, cardiovascular problems, and use of other medications, like hypertensive medications, were excluded from the study. Patients who have used anticholinergics daily for 3 years or more have a 50% higher risk of developing dementia.
Anticholinergics and Dementia
Medications That Can Cause Dementia
As stated above, anticholinergics are the worst offenders to cause dementia. These medications block acetylcholine causing involuntary muscle movement in the lungs, urinary tract, gastrointestinal tract and other body areas.
These drugs, with their brand names and function, include:
- Amitriptyline (several brand names, treats depression)
- Atropine (for slow heart rate, or to reduce secretions during surgery)
- Belladonna alkaloids (for irritable bowel syndrome and ulcers in the intestine)
- Benztropine mesylate (Cogentin, Parkinson’s disease)
- Bupropion (Chantix, Nicorette, for depression, quitting smoking)
- Clidinium (Librax, for the stomach)
- Cyclopentolate (for eye exams)
- Darifenacin (Enablex, overactive bladder)
- Dicyclomine (Bentyl, gastrointestinal tract)
- Diphenhydramine (Benadryl, antihistamine)
- Fesoterodine (Toviaz, overactive bladder)
- Flavoxate (overactive bladder)
- Glycopyrrolate bromide (treats excessive drooling)
- Homatropine hydrobromide (for eye exams)
- Hyoscyamine (numerous brands, for GI problems, Parkinson’s)
- Ipratropium (Atrovent, for asthma and COPD)
- Orphenadrine (Norflex, for muscles sprains and strains)
- Oxybutynin (Ditropan, for overactive bladder)
- Paroxetine ( Zoloft, Prozac and more, for panic attacks, depression, OCD, PTSD)
- Propantheline (numerous brand names, for overactive bladder)
- Scopolamine (prevents nausea and vomiting, used during surgeries)
- Methscopolamine bromide (treats peptic ulcers)
- Tizanidine ( Zanaflex, short acting muscle relaxer for spasms)
- Tiotropium bromide (treats asthma and COPD)
- Tolterodine (Detrol, for overactive bladder)
- Trihexyphenidyl (Artane, Parkin, Pacitane, for Parkinson’s disease)
- Trospium (for overactive bladder)
Another cause of dementia found in research studies is the number of medications an individual takes. There is a 33% chance of dementia for those taking 5 medications daily and a 54% chance of dementia for those taking 10 or more medications. Mild cognitive impairment or delirium should be investigated for individuals taking multiple medications.
Hospital Associated Dementia
Statistically, when patients over the age of 65 are hospitalized hospital delirium may occur for 20% of them. About 80% of patients cared for in the ICU will develop delirium. If delirium is not recognized it will hinder recovery and if left untreated a higher mortality rate may occur. Delirium occurs slowly, but it should clear up in a matter of days or possibly weeks.
Delirium is typically thought of like a hyperactive, agitated state with hallucinations, but delirium related to hospitalization is more often a hypoactive state. Since this delirium is hypoactive it is not often recognized by the medical staff. The patient is withdrawn, drowsy and often difficult to awake. In a study at Vanderbilt, a screening tool was developed to assess patients so the staff will recognize delirium and treat it, usually with the help of family.
Experiencing Delirium after Surgery
If you are over 55 and taking one of the medications listed above, talk with your physician to see if there are other options to treat the medical problem.
Factors that contribute to delirium or dementia include: sleep deprivation, dehydration, immobility and vision or hearing loss.
If you see a parent or older loved one exhibiting the signs of dementia, get them to a physician for evaluation. The physician will do blood work, a urinalysis to check for infection, a chest x-ray to look for pneumonia and a neurological assessment to look for stroke symptoms. It is a good idea to get a professional opinion.
Do you take any of the Anticholinergics medications listed above?
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Pamela Oglesby